Preventing Substance Use Among Youth: Behavioral and Economic Impact of Enhanced Implementation Strategies for Communities

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Quality implementation of evidence-based programs (EBPs) in community settings for youth is critical for re- ducing the burden of alcohol, tobacco and other drug use (ATOD) and its consequences. EBPs delivered in schools are an efficient way to reach large populations of young people, including those underserved by other settings, and reduce and prevent ATOD use. Yet, youth rarely receive EBPs as intended in community set- tings, including schools. Research is needed that applies implementation theories and frameworks to better understand factors related to program delivery, approaches to enhancing quality delivery through implementa- tion strategies, and the economic implications of these strategies in school settings. This training and research plan will prepare Dr. Eisman to become an independent scholar in implementing ATOD programs for youth in community settings. To address these challenges, Dr. Eisman, with the guidance of her dedicated mentorship team and institutional resources at the University of Michigan, will engage in activities, including coursework, workshops, meetings and mentored research, to achieve the following training goals: 1) Create expertise in implementation science; 2) Become proficient in economic evaluation of implementation; 3) Develop skills to foster effective community-engaged research. Dr. Eisman's long-term goal is to reduce ATOD use and its con- sequences among youth through facilitating effective delivery of EBPs in community settings. The plan in- cludes the following specific aims: 1) Identify relevant factors associated with implementation for school-based EBPs, 2) Compare the effectiveness of two implementation strategies on implementation and behavioral (ATOD use) outcomes, and 3) Conduct economic evaluation of implementation strategies. As part of the pro- posed research, Dr. Eisman will apply the CFIR (Consolidated Framework for Implementation Research) framework to studying implementation factors for EBPs in schools; this will expand the application of CFIR and inform approaches to enhancing effective EBP delivery (e.g., implementation strategies). The proposed re- search also includes a retrospective study investigating two intensities of an evidence-based implementation strategy, Replicating Effective Programs (REP) applied in a clinical setting and a pilot study comparing two in- tensities of REP with a school-based substance use prevention program. The retrospective and pilot studies will also include economic evaluation of implementation strategies on ATOD use and implementation out- comes. The pilot will investigate feasibility, appropriateness and acceptability of using REP in a school context that will be the basis of an R01. The proposed training and research plan extends current implementation re- search to focus applying implementation theories, frameworks and strategies in other community settings (schools) and on economic evaluation of implementation strategies. The results are expected to facilitate effec- tive and efficient delivery of EBPs in diverse community settings and aid in applying evidence-based imple- mentation strategies in the school context to ultimately reduce and prevent ATOD use among youth.